Independent Contractor Application

Independent Contractor Application
Contact Information
Your Name*

First NameLast Name
Company Name
Are you Incorporated?

YESNO
Address

Street Address

Street Address Line 2

CityState

Zip Code
Your E-mail Address
Business Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Do you use WiFi in the field?

YESNO
Smartphone?

iPhoneAndroidWindows/OtherNo Smartphone
Work History, Experience, and Coverage Area
Can you pass a federal background check?

YESNO
Are you a fully licensed appraiser in your state?

YESNONot Applicable
What cities, counties, or states do you cover?*
What estimating skills do you have? Check all that apply.

Automobiles/ Light TruckClassic or Exotic VehiclesRecreational VehiclesMotorcyclesHeavy EquiptmentTractor/ Trailer (ORTT)PropertyOther
Do you have 5 combined years of related estimating experience (body shop, insurance company, etc):

YESNO
What estimating systems do you have proficiency in using?

AudatexCCCProperty EstimaticsMitchellTruckEst / TruckWriterOther
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